In a prospective audit of 170 patients undergoing colorectal resection, complications occurred in 49% and mortality was 5%, with a 25-week delay from symptom onset to surgery for elective malignancy.
Observational (n=170)
No
What are the outcomes and delays in care for patients undergoing colorectal resection in a peripheral public hospital in New Zealand?
The audit highlights acceptable surgical outcomes but significant delays in treatment and advanced tumor stages at presentation in an unscreened New Zealand population.
BACKGROUND: Colorectal disease requiring surgery is common in New Zealand where there is no established national colorectal screening programme. We established an audit to review our current practice in colorectal surgery. METHODS: Prospective audit data were collected on consecutive patients undergoing colorectal resection between April 2003 and December 2004, using a standardized pro forma. RESULTS: In all, 170 colorectal resections were carried out of which 117 (69%) were for malignancy and 120 (71%) were elective. Median patient age was 72 years (interquartile range 62-78 years) and median length of stay was 10 days (interquartile range 8-14 days). Colonoscopy was the most common method of investigation. In elective patients with malignancy, the average delay between onset of symptoms and surgery was 25 weeks. Duke's stage C was the most common stage at presentation (44%). Complications developed in 83 (49%) of patients including 20 (12%) patients returned to theatre, 5 (3%) anastomotic leaks and 8 deaths (5%). In patients undergoing surgery aged over 80 (n = 40) the median length of stay was 10 days (7-14) with a complication rate of 21 (55%) including 5 (13%) who were returned to theatre and 6 (16%) deaths. CONCLUSION: This audit has confirmed that there is an acceptable level of care at Taranaki Base Hospital when compared with those in published work. Elective patients with malignancy have a delay of nearly 6 months between the onset of symptoms and surgery. Patients in Taranaki are more likely to present with an advanced stage of tumour compared with other unscreened populations.
Gollop et al. (Wed,) conducted a observational in Colorectal disease requiring surgery (n=170). Colorectal resection was evaluated on Complications. In a prospective audit of 170 patients undergoing colorectal resection, complications occurred in 49% and mortality was 5%, with a 25-week delay from symptom onset to surgery for elective malignancy.